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Repeated arthralgia associated with granulocyte colony stimulating factor administration
  1. A Tsukadaira1,
  2. Y Okubo2,
  3. S Takashi1,
  4. H Kobayashi3,
  5. K Kubo1
  1. 1First Department of Internal Medicine, Shinshu University School of Medicine, Japan
  2. 2Department of Internal Medicine, National Higashinagano Hospital, Japan
  3. 3Department of Orthopaedics, Shinshu University School of Medicine, Japan
  1. Correspondence to:
    Dr Y Okubo, Department of Internal Medicine, Higashinagano National Hospital, Uwano 2-477, Nagano, 381-8567, Japan;

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We report the case of a 69 year old man with non-small lung cancer, who developed arthralgia and myalgia twice during chemotherapy using 210 mg/day of paclitaxel and 110 mg/day of nedaplatine for every four week cycle. After starting chemotherapy, arthralgia and myalgia accompanied by rising fever suddenly occurred on the fifth consecutive day of subcutaneous administration of 100 μg/day of granulocyte colony stimulating factor (G-CSF; lenograstim). To determine the cause of the polyarthralgia we carried out arthroscopy in the most symptomatic joint. The left elbow and left hand joints were chosen for the biopsy. Microscopic findings of formalin fixed synovial tissue showed severe inflammatory infiltration accompanied by foreign body-type giant cell reaction, but no crystals or rheumatoid nodules (fig 1).

Figure 1

Microscopic findings …

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